 Aipzulman bin Rozali(bpp2017-1199)

 Alexander Nanang(bpp2017-1202)
 Alister John(bpp2016-1928)
Scabies

 Scabies is an itchy rash caused by a little mite

that burrows in the skin surface.
 The human scabies mite's scientific name is
Sarcoptes scabiei var. hominis.
 Scabies is caused by the acarus, Sarcoptes scabiei,
and is a common world-wide public health problem
with an estimated global prevalence of 300 million.
 The infestation causes considerable discomfort and
can lead to secondary infection and complications
such as post-streptococcal glomerulonephritis.
 Scabies spreads in households and environments
where there is a high frequency of intimate personal
contact.
 Sarcoptes scabiei
 Scabies
 Inappropriate application of scabietic treatments can
cause considerable irritation in other conditions. In small
children the palms and soles can be involved with
pustule formation.
 Involvement of the genital area in boys is
pathognomonic.
 The main symptom is itch.
 The clinical features include secondary eczematisation
elsewhere on the body; the face and scalp are never
involved except in the case of infants.
 Even after successful treatment the itch can continue,
and occasionally nodular lesions persist.
Itch
 The itching appears a few days after infestation.
 It may occur within a few hours if the mite is caught a
second time.
 The itch is characteristically more severe at night and
affects the trunk and limbs.
 It does not usually affect the scalp.
Burrows
 Scabies burrows appear as tiny grey irregular tracks
between the fingers and on the wrists.
 They may also be found in armpits, buttocks, on the
penis, insteps and backs of the heels.
 Microscopic examination of the contents of a burrow
may reveal mites, eggs or mite faeces (scybala).
Generalised rash
 Scabies rash appears as tiny red intensely
itchy bumps on the limbs and trunk.
 It can easily be confused with dermatitis or
hives (and may be accompanied by these).
 The rash of scabies is due to an allergy to the
mites and their products and may take
several weeks to develop after initial
infestation.
Nodules
 Itchy lumps or nodules in the armpits and
groins or along the shaft of the penis are very
suggestive of scabies.
 Nodules may persist for several weeks or
longer after successful eradication of living
mite.
Acropustulosis
 Blisters and pustules on the palms and soles are
characteristic of scabies in infants.
Secondary infection
 Impetigo commonly complicates scabies and results
in crusting patches and scratched pustules.
 Cellulitis may also occur, resulting in localised
painful swelling and redness, associated with fever.
 Pruritus
 Scabies only rarely affects the face and scalp.
 This may be the case in young babies and
bedbound elderly patients.
 Scabies
 Scabies. Pustules at a common site in a child. Burrows were present but cannot be seen at this distance.
 Scabies
 Diagnosis is made by identifying the scabietic
burrow, usually found on the edges of the fingers,
toes or sides of the hands and feet.
 Extraction of the mite using a blunt needle can be
difficult but is helpful in ensuring the correct
diagnosis, appropriate treatment and compliance.
 Inappropriate application of scabietic treatments
can cause considerable irritation in other conditions.
 In small children the palms and soles can be
involved with pustule formation . Involvement of
the genital area in boys is pathognomonic.
 The main symptom is itch.
 The clinical features include secondary
eczematisation elsewhere on the body; the face and
scalp are never involved except in the case of
infants.
 Even after successful treatment the itch can
continue, and occasionally nodular lesions persist.
 Burrows [Arrows point to mites]
 Skin scraping under microscopic test
 A test with “low power microscopic
field” of lesion and burrow
 Topical treatment of scabies is usual and involves
the affected individual and all asymptomatic family
members/physical contacts to ensure eradication.
 Two applications one week apart of an aqueous
solution of either permethrin or malathion to the
whole body, excluding the head, is usually
successful.
 In some clinical situations such as poor compliance,
immunocompromised individuals and heavy
infestations (Norwegian scabies), systemic
treatment with ivermectin (200 µg/kg) as a single
dose would be appropriate.
 (A)5% Permethrin w/v lotion-apply thoroughly to all
body parts. Leave on for 8-14 hours . Not
recommended for children < 2 years old
 (A)Gamma benzene hexachloride 1% cream(adult)-
apply a thin of 1 topical preparation onto all skin
areas. Completely wash off from the body with
warm water after 8-12 hrs.
 (B)crotamiton 10% cream- apply to the whole
body. 2nd application after 24 hr later. May
need to use once daily for up to 5 days
 (C)Benzyl benzoate 25% emulsion(adult) and
benzyl benzoate 12.5% emulsion(child <2
years)-after bath, apply over the whole body
and leave on for 24 hours then wash off.
Reapply for another 24 hours, the first repeat
application should be within 5 days of the
initial application, a 3rd appklication may be
required in some cases
 Analgesics if needed
 Anti histamine
 Antibiotic for secondary infection
 To reduce the risk of the treatment failing:
 Ensure the scabicide is applied to the whole body from the
chin down.
 Leave it on for the recommended time and reapply it after
washing.
 Apply the scabicide under fingernails using a soft brush.
 Obtain antibiotics from your doctor if there is crusting and
secondary infection.
 Ensure all close contacts are treated whether or not they are
itchy.
 Towel, clothes, bedding should not be shared.
 Self hygience
 Avoid direct physical contact
…..Please Take Care of your
hygience …..